Depression, healing, and recovery from coronary artery bypass surgery

BACKGROUND: Effects of postoperative depression on recovery from coronary artery bypass grafting have not been widely studied. OBJECTIVES: To evaluate emotional and physical recovery after bypass surgery and investigate associations between depressive symptoms and infections and impaired wound healing in patients with high and low levels of depressive symptoms. METHODS: A nonrandomized, comparative, longitudinal design was used to study 72 bypass surgery patients without serious noncardiac comorbidities who were available for follow-up after discharge. Patients completed questionnaires to assess depressive symptoms, emotional recovery, and physical recovery within 48 hours after extubation, at discharge from the hospital, and 6 weeks later and performed 6-minute walk tests at the last 2 times. Infections and impaired wound healing (as indicated by positive cultures, antibiotic treatment, or extra treatments, such as debridements or incisions and drainage) were identified by chart audit. RESULTS: At discharge, patients with higher depressive symptom scores (indicating more symptoms) reported poorer emotional recovery (P < .001) and poorer physical recovery (P = .007) and achieved shorter walking distances (P < .001) than did patients with lower scores (indicating fewer symptoms). Six weeks after discharge, emotional and physical recovery remained lower in patients with more depressive symptoms (P < .001). Infections and impaired wound healing were more common among patients with higher depressive symptom scores (46%) than among patients with lower scores (19%, P = .03). CONCLUSIONS: After bypass surgery, depressive symptoms are associated with infections, impaired wound healing, and poor emotional and physical recovery.